Pneumoperitoneum deteriorates intratidal respiratory system mechanics: an observational study in lung-healthy patients

Wirth, Steffen; Biesemann, Andreas; Spaeth, Johannes; Schumann, Stefan

doi:10.1007/s00464-016-5029-0

Cited by 14 publications

(11 citation statements)

References 30 publications

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“…Chronic obstructive pulmonary disease (COPD) has been identified as an independent risk factor for postoperative pulmonary complications following open and laparoscopic abdominal surgery [4, 5]. Physiologic changes that accompany COPD during pneumoperitoneum include reduction in dynamic compliance and reduction in functional residual capacity, increasing risk of atelectasis, hypoxemia, and subsequent respiratory failure [6, 7]. Thus, diminished pulmonary status has been perceived as a relative contraindication to minimally invasive surgery due to the belief that this patient subset will not tolerate pneumoperitoneum and be predisposed to higher rates of postoperative respiratory complications.…”

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confidence: 99%

Respiratory complications after colonic procedures in chronic obstructive pulmonary disease: does laparoscopy offer a benefit?

et al. 2017

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confidence: 99%

Respiratory complications after colonic procedures in chronic obstructive pulmonary disease: does laparoscopy offer a benefit?

et al. 2017

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“…The single incision laparoscopy needs sufficient operating room inner the abdomen; thus, the high pressure of pneumoperitoneum might affect the respiratory system. [29,30] For an enhanced cosmetic look of the 2-port laparoscopy, the infra-umbilical incision and 3 mm scars near the umbilical were made nearly invisible with the help of topical skin adhesive to avoid suturing.…”

Section: Discussionmentioning

confidence: 99%

Modified 2-port laparoscopic herniorrhaphy with Kirschner wire in children

Cao

Chen

et al. 2018

Medicine

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Background: Pediatric inguinal hernia is one of the most common diseases in children, and laparoscopy is the main surgical method. This study aims to evaluate the efficacy of a new modified 2-port laparoscopic herniorrhaphy with Kirschner wire (TLHK) for inguinal hernia in children. Methods: A total of 5304 children with inguinal hernia hospitalized at the Jiangmen Center Hospital from June 2003 to May 2016 were enrolled in this retrospective study. Four thousand one hundred thirty-five children underwent TLHK that comprised the observation group, while 1169 received single incision laparoscopy (SIL) as the control group (CG). A propensity score matched cohort study was conducted between these groups. We included all patients who were diagnosed as inguinal hernia and matched comparators with a proportion of 1:1. The propensity score was calculated using logistic regression with forward stepwise selection in 4 variables. The patients’ operative details, intra- and postoperative complications, and postoperative hospital stay were analyzed. The follow-up lasted from 1 month to 2 years. Results: Among 5304 potential patients, the propensity score identified 270 (135 TLHK cases and 135 comparators) patients. The age, sex, body mass index, and the hernia type and location did not differ between CG and TLHK. TLHK group had a shorter operative time (unilateral: 17.4 ± 3.35 minutes vs 20.7 ± 3.71 minutes; bilateral: 20.4 ± 5.17 minutes vs 25.2 ± 5.43 minutes), less complications (2.10% vs 2.65%), lower recurrence rate (0% vs 4.44%), and similar hospital stay (2.3 ± 1.1 vs 2.1 ± 1.3) as compared with CG. No iliac vessel injury, spermatic cord vessels injury, vas deferens injury, or iatrogenic cryptorchidism occurred in either of the groups. Conclusion: TLHK is a safe and feasible treatment for inguinal hernia in children due to less invasion and less recurrence rate than SIL.

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“…The reasons might be lower pain rate, less complication rate in laparoscopic surgery, and also it might be attributable to the enhanced post-operative recovery of lung function in laparoscopic group [23, 24]. Besides, a lung-protective PEEP during pneumoperitoneum might be also valuable for preventing intratidal recruitment/derecruitment [25]. …”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes and propensity score matching analysis: rectal cancer resection for patients with elevated preoperative risk

et al. 2016

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BACKGROUNDIt is still controversial about the treatment strategy for rectal cancer patients with elevated operative risk and elder rectal cancer patients.METHODSThis study presented a retrospective single center experience in rectal cancer proctectomy for high operative risk patients. High operative risk patient was defined as Cr-POSSUM > 5% combined with associated risk factors. 220 in 1477 consecutive patients met the inclusion criteria.RESULTS132 patients were selected (66:66) after propensity score matching. The total complication rate between conventional open rectal resection (71 %) and laparoscopic surgery (41%) was significantly different (p = 0.0005). There is a significantly positive correlation between open surgery and advanced Dindo Classification (p = 0.02). Cr-POSSUM is positively correlated with Dindo Classification (p = 0.01). There was no significant difference in survival rate among stage I∼II, different age groups or different Cr-POSSUM score sub-groups. However, stage III-IV tumor patients in laparoscopic group experienced improved overall survival rate. (p < 0.0001). For patients with preoperative pulmonary or renal disease, patients in laparoscopic group also had better long term prognosis (p = 0.03, p = 0.049).CONCLUSIONSThe results demonstrate the potential advantages of laparoscopic rectal cancer resection for high operative risk patients, especially for the patients with preoperative respiratory or renal disease and stage III cancer.

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Pneumoperitoneum deteriorates intratidal respiratory system mechanics: an observational study in lung-healthy patients

Cited by 14 publications

References 30 publications

Respiratory complications after colonic procedures in chronic obstructive pulmonary disease: does laparoscopy offer a benefit?

Respiratory complications after colonic procedures in chronic obstructive pulmonary disease: does laparoscopy offer a benefit?

Modified 2-port laparoscopic herniorrhaphy with Kirschner wire in children

Long-term outcomes and propensity score matching analysis: rectal cancer resection for patients with elevated preoperative risk

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